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    Dislocation: Muhammad Shahiduzzaman

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    Alice
    This document discusses dislocations of various joints. It defines dislocation as the displacement of a joint where the joint capsule and ligaments are disrupted. The most common dislocations are of the shoulder, hip, elbow, finger joints, and cervical facet joints. Acute dislocations should be reduced as soon as possible, usually through closed reduction with anesthesia. Complications can include nerve and vessel injuries, recurrent dislocations, arthritis, and stiffness. Proper reduction techniques and immobilization after reduction are emphasized to prevent complications and achieve proper healing.

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    Dislocation: Muhammad Shahiduzzaman

    Uploaded by

    Alice
    38 views30 pages
    This document discusses dislocations of various joints. It defines dislocation as the displacement of a joint where the joint capsule and ligaments are disrupted. The most common dislocations are of the shoulder, hip, elbow, finger joints, and cervical facet joints. Acute dislocations should be reduced as soon as possible, usually through closed reduction with anesthesia. Complications can include nerve and vessel injuries, recurrent dislocations, arthritis, and stiffness. Proper reduction techniques and immobilization after reduction are emphasized to prevent complications and achieve proper healing.

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    This document discusses dislocations of various joints. It defines dislocation as the displacement of a joint where the joint capsule and ligaments are disrupted. The most common dislocations are of the shoulder, hip, elbow, finger joints, and cervical facet joints. Acute dislocations should be reduced as soon as possible, usually through closed reduction with anesthesia. Complications can include nerve and vessel injuries, recurrent dislocations, arthritis, and stiffness. Proper reduction techniques and immobilization after reduction are emphasized to prevent complications and achieve proper healing.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    38 views30 pages

    Dislocation: Muhammad Shahiduzzaman

    Uploaded by

    Alice
    This document discusses dislocations of various joints. It defines dislocation as the displacement of a joint where the joint capsule and ligaments are disrupted. The most common dislocations are of the shoulder, hip, elbow, finger joints, and cervical facet joints. Acute dislocations should be reduced as soon as possible, usually through closed reduction with anesthesia. Complications can include nerve and vessel injuries, recurrent dislocations, arthritis, and stiffness. Proper reduction techniques and immobilization after reduction are emphasized to prevent complications and achieve proper healing.

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    Dislocation

    Muhammad Shahiduzzaman
    Professor & Head Department
    Orthopaedic Surgery. DMC
    Definition

     It is complete and persistent displacement of a


    joint in which at least part of the supporting
    joint capsule and some of its ligaments are
    disrupted.
    Types of dislocation
     Congenital
     Acquired
    1. Traumatic
    2. Pathological e.g. TB hip, Septic Arthritis
    3. Paralytic e.g. Poliomyelitis, cerebral palsy, etc
    4. Inflammatory disorders, rheumatoid
    arthritis,etc
    Dislocation
     No joint is immune from dislocation
     Most commonly occur in the following joints.
     Shoulder
     Hip

     Elbow

     Metacarpophalengeal joint

     Facet joint dislocation in cervical spine.

     Acromiclavicular joint dislocation.


    Typical deformities in dislocation
     Shoulder- abduction deformities
     Elbow- flexion deformities
     Hip:
    Anterior- flexion abduction and internal rotation
    deformities.
    Posterior-flexion, adduction and internal rotation deformity
     Knee-flexion deformity
     Ankle-varus deformity
    Investigations
     Radiograph of the affected part should include
    anterior posterior and lateral views and
    sometimes special views needed.
     CT Scan
    Principles of management
     Acute dislocation should be reduced as soon as
    possible.
     Open reduction is rarely necessary for acute
    dislocation.
     Close reduction with intravenous analgesia and
    sedation or under GA should be attempted first
    for most uncomplicated dislocation.
    Complication
    1. Acute: Injury to peripheral nerve and vessels
    2. Chronic: Unreduced dislocation
    Recurrent dislocation
    Traumatic osteoarthritis
    Joint stiffness
    Avascular necrosis
    Myositis ossificans
    Caution !
     Excessive force should not be used in close
    reduction.
     Forceful manipulation may lead to fracture.

     Interposition of soft tissue, bony fragment or


    buttonhole in capsule may make close reduction
    impossible.
    Remember in Dislocation
     It is an orthopedic emergency.
     Reduction should be quick and prompt.
     Reduction should always be under G/A or
    sedation.
     Swelling is less in compared to fractures.
     Movements are more restricted than in fractures.
    Remember in Dislocation
     Closed reduction is sufficient in most of the
    times.
     Open reduction is restored to if specifically
    indicated.
     Reduction techniques should always be very
    gentle.
     Pain will not subside by splinting unlike
    fractures.
    Shoulder Dislocation
     Types:
     Anterior dislocation: Varities of dislocations like
    Subcoracoid, subglenoid, sub-infraclavicular,
    inferior.
     Posterior Dislocation
    Radiological Images
    Anterior Dislocation
    Radiological Images
    Anterior dislocation

     Occurs with the arm


    held in abduction and
    external rotation.
    Radiological Images
    Posterior Dislocation

     Causes
    1. Epilepsy
    2. Electrocution
    Reduction Techniques

     Stimson’s Gravity Method


    Reduction Techniques

    KOCHER’s Method
    Reduction Techniques
    After Treatment
     The arm should be fasten to the chest with a
    body bandage minimum period of three weeks.
    Hip Dislocation

    Types:
    A. Posterior Dislocation

    B. Anterior Dislocation

    C. Center Dislocation
    Mechanism of Dislocation
    Hip Dislocation
     Clinical Features:
    o H/O Trauma
    o The patient has a flexion,
    adduction and medial
    rotational deformity of
    the affected limb.
    o Hip movement grossly
    restricted.
    Radiological Images
    Hip dislocation
    Hip Dislocation
    Reduction techniques
     The patient is supine on
    the floor under GA.
     The hip is flexed to 90
    degree.
     Assistant stabilizing the
    pelvis.
     Longitudinal traction is
    applied.
    Hip Dislocation
    After Treatment
     The patient is put on surface traction for three
    weeks.
     Full weight bearing is permitted after 6 wks.
    Elbow Dislocation
     Commonly due to fall on
    outstretched hand.
     Closed reduction and long
    arm back slab for 3 wks is
    the treatment of choice.
    MP Joint Dislocation
    IP Dislocation

     Reduction Techniques..
    Facet joint Dislocation
     Commonest cervical
    spinal injury.
     May lead to
    quadriplegia.
     May be treated
    conservatively by
    Traction.
     May also need Open
    Reduction
    Thank you for your attention.

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